Healthcare Provider Details

I. General information

NPI: 1780659151
Provider Name (Legal Business Name): OAK PARK IMAGING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S MAPLE AVE SUITE 1100
OAK PARK IL
60304-1091
US

IV. Provider business mailing address

1730 PARK ST SUITE 101
NAPERVILLE IL
60563-2688
US

V. Phone/Fax

Practice location:
  • Phone: 708-660-6710
  • Fax: 708-660-6723
Mailing address:
  • Phone: 630-718-0200
  • Fax: 630-718-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM V MOLLIHAN
Title or Position: PHYSICIAN / OWNER
Credential: M.D.
Phone: 630-718-0200